Basic Information
Provider Information
NPI: 1437558343
EntityType: 2
ReplacementNPI:  
OrganizationName: STAR VIEW BEHAVIORAL HEALTH, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: STAR VIEW CS SAN BERNARDINO
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1501 HUGHES WAY
Address2: SUITE 150
City: LONG BEACH
State: CA
PostalCode: 908101878
CountryCode: US
TelephoneNumber: 3102216336
FaxNumber:  
Practice Location
Address1: 1585 S D ST
Address2: STE 101
City: SAN BERNARDINO
State: CA
PostalCode: 924083235
CountryCode: US
TelephoneNumber: 9093882222
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/15/2014
LastUpdateDate: 01/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DUNLAP
AuthorizedOfficialFirstName: KENT
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT AND CHIEF EXECUTIVE OFFIC
AuthorizedOfficialTelephone: 3102216336
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


Home